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ea0086oc4.5 | Adrenal and Cardiovascular | SFEBES2022

Comparison of prednisolone and modified-release hydrocortisone capsules in the treatment of congenital adrenal hyperplasia: dose and disease control

Rees Aled , Merke Deborah , Arlt Wiebke , Pierriere Aude , Hirschberg Angelica , Juul Anders , Newell-Price John , Perry Colin , Prete Alessandro , Reisch Nicole , Stikkelbroeck Monica , Touraine Philippe , Coope Helen , Lewis Alexander , Porter John , Ross Richard

Introduction: First-line treatment for congenital adrenal hyperplasia (CAH) is hydrocortisone1. When adequate control is not achieved, prednisolone (or its prodrug prednisone) are often used. However, there has been no formal comparison of disease control in CAH comparing prednis(ol)one vs hydrocortisone and patients are often on a glucocorticoid dose that exceeds the guideline recommended dose of hydrocortisone (≤25 mg/day)1,2. We report an interim...

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ea0077ec1.3 | Clinical Endocrinology Trust Best Abstract Clinical | SFEBES2021

Phase 3 and extension study of modified-release hydrocortisone in the treatment of congenital adrenal hyperplasia

Merke Deborah P , Mallappa Ashwini , Arlt Wiebke , De La Perriere Aude Brac , Hirschberg Angelica Linden , Juul Anders , Newell-Price John D C , Perry Colin Graham , Prete Alessandro , Rees Aled , Reisch Nicole , Stikkelbroeck Monica , Touraine Philippe A , Lewis Alexander , Maltby Kerry , Treasure Peter , Porter John , Ross Richard John M

Background: Patients with congenital adrenal hyperplasia (CAH) due to classic 21-hydroxylase deficiency have poor health outcomes. We compared disease control in CAH adults treated with modified release hydrocortisone (MRHC, Chronocort®, Diurnal Ltd) versus standard glucocorticoid (GC).Methods: 6-month, Phase 3 study in 122 patients randomised to either MRHC twice daily or standard GC followed by safety extension study on MRHC. Patients had 24-hr 17...

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ea0081rc2.6 | Rapid Communications 2: Adrenal and Cardiovascular Endocrinology 1 | ECE2022

Modified release hydrocortisone capsules (MRHC, Efmody) improve control of congenital adrenal hyperplasia (CAH) on a lower glucocorticoid dose than standard treatment

Rees Aled , Merke Deborah P , Arlt Wiebke , Brac De La Periere Aude , Linden Hirschberg Angelica , Juul Anders , Mallappa Ashwini , Newell-Price John D. C. , Graham Perry Colin , Prete Alessandro , Reisch Nicole , Stikkelbroeck Monica , Touraine Philippe A , Coope Helen , Porter John , Ross Richard John M

Background: The therapeutic goal in CAH is androgen control on the lowest achievable glucocorticoid dose, preferably an adrenal replacement dose (15-25 mg hydrocortisone a day)1. However, the glucocorticoid dose required to control androgens frequently exceeds that required for adrenal replacement2. Modified-release hydrocortisone (MRHC) capsules, (Efmody, Diurnal Ltd, Cardiff, UK), replicate cortisol diurnal rhythm and improve CAH control compared to sta...

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ea0081rc2.7 | Rapid Communications 2: Adrenal and Cardiovascular Endocrinology 1 | ECE2022

Improved biochemical control with modified-release hydrocortisone overturns the impaired fludrocortisone effect in salt-wasting CAH patients

Tschaidse Lea , Reisch Nicole , Arlt Wiebke , Brac De La Perriere Aude , Linden Hirschberg Angelica , Juul Anders , Mallappa Ashwini , Merke Deborah P , Newell-Price John DC , Perry Colin Graham , Prete Alessandro , Rees Aled , Stikkelbroeck Monica , Touraine Phillippe A , Coope Helen , Porter John , Ross Richard John M , Quinkler Marcus

Background: Patients with salt-wasting congenital adrenal hyperplasia (CAH) due to classic 21-hydroxylase deficiency require glucocorticoid (GC) and mineralocorticoid (MC) replacement therapy. Recently, it was shown that twice daily modified-release hydrocortisone hard capsules (MRHC, Efmody®, Diurnal Ltd) improved control of CAH with most patients showing good disease control versus standard GC therapy. However, no data has been reported on the renin-angiotens...

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ea0081rc2.8 | Rapid Communications 2: Adrenal and Cardiovascular Endocrinology 1 | ECE2022

Fertility in congenital adrenal hyperplasia (CAH) patients on modified release hydrocortisone capsules (MRHC, Efmody)

Tschaidse Lea , Quinkler Marcus , Arlt Wiebke , Brac De La Perriere Aude , Linden Hirschberg Angelica , Juul Anders , Mallappa Ashwini , Merke Deborah P , Newell-Price John DC , Perry Colin Graham , Prete Alessandro , Rees Aled , Stikkelbroeck Monica , Touraine Philippe A , Coope Helen , Porter John , Ross Richard John M , Reisch Nicole

Background: Fertility in CAH women is impaired: 0.25 live births vs 1.8 in the UK population and 45% have irregular menses vs 13.6% in healthy women1. Male fertility is also impaired in CAH with oligospermia reported in 48%2. Treatment of infertility usually involves increasing the glucocorticoid dose to normalise adrenal androgens and progesterone to facilitate ovulation and implantation, respectively. Modified-release hydrocortisone (MRHC) capsules, (Ef...

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ea0090oc5.3 | Oral Communications 5: Adrenal and Cardiovascular Endocrinology 1 | ECE2023

Switching patients with Congenital Adrenal Hyperplasia to Modified release hydrocortisone capsules: relative bioavailability and disease control

Ross Richard John M , Rees Aled , P. Merke Deborah , Arlt Wiebke , Brac De La Perriere Aude , Linden Hirschberg Angelica , Juul Anders , D. C. Newell-Price John , Perry Colin Graham , Prete Alessandro , Reisch Nicole , Stikkelbroeck Monica , A. Touraine Philippe , Mallappa Ashwini , Aslam Naila , Coope Helen , Porter John

Background: Modified-release hydrocortisone (MRHC) capsules (Efmody, Diurnal Ltd, Cardiff, UK), have been developed to replicate the cortisol diurnal rhythm and shown to improve CAH disease control1. We have examined relative bioavailability of MRHC and disease control of congenital adrenal hyperplasia (CAH) patients switched from standard therapy to MRHC.Methods: An open label, randomised, 2 period, crossover study comparing the relative bioavailability...

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Endocrine Abstracts